point_of_dispensing_field_operations_guide · web view- intra-pod dispensing log (word and excel)...

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Oregon Medical Countermeasure WorkgroupJanuary 2019

Point_of_Dispensing_Field_Operations_Guide

TABLE OF CONTENTSTopic Page #

Acronyms and Terms.......................................................................................................4Overview...........................................................................................................................5POD Operations – A Primer.............................................................................................6POD Management Structure/Organization Chart.............................................................8

Dispensing POD Staffing Guidelines.......................................................................9Vaccination POD Staffing Guidelines....................................................................10

POD LayoutsFig. 1 Basic, emphasizing unidirectional flow........................................................12Fig. 2 Detailed, emphasizing stations....................................................................13Fig. 3 External Model for POD ground layout........................................................14

Signage and Color-Coding.............................................................................................15Local to Federal SNS Resource Request Flow Chart....................................................17Medical Section Considerations.....................................................................................18

Dispensing Algorithm.............................................................................................20Exposure Roster Planning..............................................................................................21Resources......................................................................................................................30

Appendix A – Standard Operating Procedures........................................................A-1SOP 1 - POD Activation and Deployment.................................................................SOP 2 - POD Stand Up.............................................................................................SOP 3 - POD Operations..........................................................................................SOP 4 - Supply and Inventory Operations................................................................SOP 5 - POD Personnel Credentialing......................................................................SOP 6 - POD Personnel Management and Scheduling............................................SOP 7 - POD Security...............................................................................................SOP 8 – Safety..........................................................................................................SOP 9 - Resource Accountability..............................................................................SOP 10 - POD Demobilization..................................................................................SOP 11 - POD After Action Reports..........................................................................

Appendix B – Job Action Sheets (JAS)....................................................................B-1Job Action Sheet - Group 1..................POD Supervisor......................................JAS 1-1 - Personnel Coordinator..............................................................................JAS 1-2 - Public Information Officer..........................................................................JAS 1-3 - Liaison Officer...........................................................................................JAS 1-4 - Safety Officer............................................................................................

Job Action Sheet - Group 2……….……Medical Unit Leader...............................JAS 2A-1- Medication Task Force Leader.............................................................JAS 2A-2 – Pharmacist.............................................................................................JAS 2A-3 - Vaccinators/Dispensers..........................................................................JAS 2A-4 - Vaccinator/Dispenser Asst......................................................................JAS 2B-1 – Screening/Triage Task Force Leader................................................JAS 2B-2 - Triage Physician/Nurse...........................................................................JAS 2B-4 - Intake Form Screener.............................................................................

POD FOG January 2019 1

JAS 2B-5 - Medical Forms Screener.........................................................................JAS 2B-6 – Triage.....................................................................................................JAS 2C-1 - Behavioral Health Staff........................................................................

Job Action Sheet - Group 3…Facilities Unit Leader............................................JAS 3-1 - Facilities Representative...........................................................................JAS 3-2 - Information Technology.............................................................................JAS 3-3 - Communications/Ham Radio....................................................................JAS 3-4 - Inventory Manager....................................................................................JAS 3-5 - Supply Runners.........................................................................................JAS 3-6 - Dispensing Supply Runners......................................................................JAS 3-7 – Runners....................................................................................................

Job Action Sheet - Group 4…POD Flow/Education Unit Leader .......................JAS 4-1 – Greeters....................................................................................................JAS 4-2 - Forms & Distribution..................................................................................JAS 4-3 – Interpreters...............................................................................................JAS 4-4 - Flow Monitor..............................................................................................JAS 4-6 - Health Educator.........................................................................................

Job Action Sheet - Group 5...Security Unit Leader..............................................JAS 5-1 – Security.....................................................................................................JAS 5-2 - Traffic Control............................................................................................

Appendix C – Just In Time Training (JITT) Sheets..................................................C-1JIT #1 - Badging and Credentialing...........................................................................JIT #2 – Communications.........................................................................................JIT #3 - Information Technology (IT).........................................................................JIT #4 - Traffic Control..............................................................................................JIT #5 – Triage..........................................................................................................JIT #6 - First Aid........................................................................................................JIT #7 – Signage.......................................................................................................JIT #8 - Materials Handling.......................................................................................JIT #9 - Pharmaceutical Inventory Room (PIR)........................................................JIT #10 – Dispensing................................................................................................JIT #11 - Staff Briefings.............................................................................................JIT #12 - Shift Change Briefings...............................................................................JIT #13 - Runners

Appendix D – Blank Forms........................................................................................D-11 - Master Personnel Roster...................................................................................2 - Sign In/Out Logs................................................................................................3 - Personnel Shift Schedule Form (Word and Excel)............................................4 - Example POD Badges.......................................................................................5 - POD Supply BIN Cards......................................................................................6 - Intra-POD Dispensing Log (Word and Excel)....................................................7 – Antibiotic Screening Form.................................................................................8 – Antibiotic Screening Form with Contact Information.........................................9 - Medical Referral Letter.......................................................................................10 - Doxycycline Crushing Instructions (Home Preparation) - FDA approved ........


11 - Drug/Agent Fact Sheets – Instructions and special considerations..................12 – Exposure Roster……………………………………………………………………

* A scanable influenza vaccination intake form is forthcoming. For updates, contact the Oregon Immunization Program’s (OIP) Preparedness Epidemiologist or the OIP ALERT Immunization Information System manager.


ACRONYMS AND TERMS

AOC Agency Operations Center

Category A Agents Anthrax, Botulism, Plague, Smallpox, Tularemia, and Viral Hemorrhagic Fevers including Ebola

CDC Centers for Disease Control and Prevention

CPR Cardio-Pulmonary Rescue

CERT Community Emergency Response Team

CRI Cities Readiness Initiative

DOC Department of Operations

ECC Emergency Coordination Center at State OEM

EMS Emergency Medical Services

EMT Emergency Medical Technician

EOC Emergency Operations Center

ESF Emergency Support Function

FDA United States Food and Drug Administration

FOG Field Operations Guide

HAN Health Alert Network

HHS U.S. Department of Health and Human Services

IAPIncident Action Plan. A document that communicates response objectives, strategies and tactics. Resources are identified and assigned are communicated within the IAP.

ICP Incident Command Post

ICS Incident Command System

IT Information Technology

JAS/JAG Job Action Sheet/Job Action Guide

JITT Just-In-Time Training

LDS Local Distribution Site

LE Law Enforcement

LPHA Local Public Health Authority

MCM Medical Countermeasures

MRC Medical Reserve Corps

OHA Oregon Health Authority


OIP Oregon Immunization Program

OEM Oregon Office of Emergency Management

PHD Public Health Division

PIO Public Information Officer

POD Point of Dispensing

PPE Personal Protective Equipment

Prophylaxis A medicine, vaccine or device used to prevent disease

RSS Receiving, Staging and Storing

SNS Strategic National Stockpile

SOP Standard Operating Procedures

Throughput The rate of people moving through a POD over a given period (e.g., number of individuals per hour)


OVERVIEW

The purpose of this document is to provide a standardized point of dispensing (POD) field operating guide (FOG) for use in POD planning by counties and tribes in the state of Oregon. The POD FOG describes how to set up and manage PODs that are scalable and adaptable in the field. The information in the FOG may be:

1. Adopted by local public health authorities (LPHAs) and tribes that do not have a POD section in their emergency response plan

2. Used by counties and tribes to amend existing POD plans, and3. Used by State, County, and Tribal personnel to stand-up a POD anywhere in

Oregon. The FOG assumes that POD staff are working under the Incident Command System (ICS), which is a widely-used management tool for organizing and coordinating a response.

The Three POD ModelsThis document addresses mass dispensing medical countermeasures (MCM) using antibiotics and antivirals and administering vaccines of a given population. The mass dispensing portion addresses two types of PODs: medical model at which clients are screened for drug allergies, drug interactions, and health conditions that may affect what medications they should receive; and non-medical model at which clients are expected to self-screen themselves to determine whether they should be taking the medications being distributed. Each of the three POD types (dispensing medical model, dispensing non-medical model, and vaccination POD) have slightly different characteristics and operational requirements. When planning for PODs be sure to take the different models into account.

During public health emergency, the County and State public health officials work together to determine whether a medical or non-medical model is used in the PODs. The criteria for the Health Officer selecting a non-medical model for rapid dispensing depends on the estimated number of people exposed, potential severity of the disease and/or the amount of time available to dispense the medication. Health officials consult with the policy makers and notify them of the decision to use a medical or non-medical model.

Legal Authorities and Policy Considerations<<Annex XX>> contains Legal Authorities pertaining to rules and statutes related to public health emergencies.

The following Policy Considerations are allowable but may be adapted to support your county or tribal nation’s operations:

1. There is no limit to the number of antibiotic regimens that one individual may pick up at a POD. The POD Group Supervisor may impose a limit if an individual’s actions are suspect.


2. Child 12 years of age and older, if unaccompanied by an adult, may pick up medication at a POD. Permitting child less than 12 years of age to pick up medication is at the discretion of the POD Supervisor.

3. No identification is required to pick up medication at a POD.4. If possible, a pharmacist, physician or dentist is at each POD, to provide consultation

for dispensing of medications.5. Each county Emergency Operations Center (EOC) is responsible to provide security

and crowd control with local law enforcement officers for the PODs. This may be a combination of law enforcement (LE) and private security officers. LE and security officers follow the Use of Force guidelines of their respective employing agency.

POD OPERATIONS

This section of the POD FOG contains a basic overview of POD operations. Refer to the Appendices for more detail.

Appendix A - Standard Operating Procedures

POD Management and Structure/Organization Chart and Staffing GuidelinesFOG reference: Appendix A, SOP #2, Attachment 2-1The Incident Command System (ICS) organization chart provides positions and lines of authority and communication in a POD. This structure can expand and contract according to the needs and capabilities of the jurisdiction.

Internal POD LayoutFOG reference: Appendix A, SOP #2, Attachment 2-3.The first internal layout presents the basic station concepts for standing up a POD. This basic layout emphasizes unidirectional flow for dispensing medication or vaccine to the public. The second internal layout provides more detailed information about PODs by emphasizing POD stations.

External POD LayoutFOG reference: Appendix A, SOP #7, Attachments 7-2, 7-3, and 7-4.Planning considerations for functions outside of the POD are presented in the external layout.

Resource Requests ProceduresFOG reference: Appendix A, SOP#4Local resources must be exhausted, or expected to be exhausted, before state and federal resources can be requested. All requests for resources go from the LPHA to the County EOC to the State Emergency Coordination Center (ECC) using OpsCenter. From the State ECC requests are forwarded to the State ESF-8 (Public Health and Medical) Agency Operations Center (AOC), in this case Oregon Public Health Division’s (PHD) AOC. The PHD requests federal assets as soon as the Governor or their designee determines that it is prudent to do so


to protect the public’s health. Please refer to Page 18 Local to State to Federal SNS Resource Request Flow Chart for resource request flow from LPHA to State.

Oregon Public Health Division receives the SNS assets at its Receiving, Staging and Storing (RSS) warehouse and ships the Medical Countermeasures (MCM) and materiel to one preidentified site per county known as the Local Distribution Site (LDS) as requested by each County.

Medical Section ConsiderationsFOG reference: Appendix A, SOP #3 and Appendix D, POD Forms and Information.Planning for the dispensing of medical on a large scale requires special forms and considerations. This section discussed a few larger issues and provides recommendations for tools to consider in supporting this effort.

Appendix B - Job Action Sheets

On page <<10>> there is an organizational chart which outlines possible positions in a POD. In Appendix B, the accompanying Job Action sheets are made available to inform people of their roles and responsibilities.

Appendix C – Just-In-Time Training (JITT)

Signage and Color-CodingFOG reference: Appendix C, JITT #7.This section discusses how signs and color-coding can be used to ensure good POD throughput including a model color-coded algorithm for post exposure anthrax.

JITT includes:q Response objectives and communication messages for the current shiftq Knowledge of the reporting structure within each team, e.g., POD organization chart

and flow; task training based on Job Action Sheet (JAS)q Other job aide information such as checklists, standing orders, guidelines, fact sheets,

radio use, supply order and re-order procedures, etc.

Additional briefings and JITT occurs by supervisors and team leads at each shift change and as needed. Additionally, a summary about a helpful resource, the Inclusive Just-in-Time Training (IJITT) Toolkit for Mass Prophylaxis/Point of Dispensing (POD) Operations is made available in this appendix.

Appendix D - POD FormsThe templates of all the forms you need in the POD are in this Appendix.



Example Organization Chart

Minimum POD Staffing and Space Planning Chart

Instructions for this chart:q These estimates are based on dispensing antibiotics within an 8-hour period (a typical work day).q The estimated number of people coming through per hour is in the left-hand column.q The minimum number of recommended staff are suggested and listed by position. Anytime there are POD sites

without staff in all possible positions, it is expected that existing staff perform multiple job functions (i.e. an Operations Chief performs functions of helping to complete forms, screening and dispensing if they are the only person working - or the Logistics chief performs inventory and personnel coordination work).

q Breaking functions down increases efficiency but also requires more space.q The two functions that take the most time include completing the screening form and making screening

recommendations.q Incident Command System (ICS) suggests Span of Control when assigning people to positions. Three to seven

people are assigned to one supervisor or team lead in the Span of Control model. Five people assigned to one supervisor is optimal.

q Please see next page for the Planning Chart.


Minimum POD Staffing and Space Planning ChartTotal # of pplServed

# of Ppl/ Hour

Minimum Square Feet*

POD Sup. Runner Greeter Forms

Reviewer Screeners Dispensers Inventory Manager

Security Lead

Safety Officer

Total Recommended Staff

400 50 200 1 1 1 1 1 1 6800 100 300 1 1 1 3 1 1 81200 150 500 1 1 1 2 2 1 1 101600 200 1,000 1 1 2 1 3 2 1 1 1 142000 250 2,000 1 1 2 1 3 3 1 1 1 152400 300 3,000 1 1 2 2 4 4 1 2 1 192800 350 3,000 1 1 3 3 5 4 1 2 1 223200 400 4,000 1 1 4 2 5 5 1 2 1 243600 450 4,000 1 1 4 3 6 5 1 2 1 264000 500 5,000 1 1 4 3 6 6 1 3 1 284400 550 5,000 1 1 5 4 7 6 1 3 1 324800 600 6,000 1 1 6 4 7 7 1 3 1 345200 650 6,000 1 1 6 4 8 7 1 3 1 355600 700 7,000 1 1 6 4 8 8 1 3 1 366000 750 7,000 1 1 6 4 9 8 1 3 1 376400 800 8,000 1 1 6 5 9 9 1 3 1 396800 850 8,000 1 1 6 5 10 9 1 3 1 407200 900 9,000 1 1 6 5 10 10 1 3 1 417600 950 9,000 1 1 6 5 11 10 1 3 1 428000 1000 10,000 1 1 6 5 12 11 2 4 1 47

Modified NACCHO Closed POD Toolkit Chart


Staffing for Standard Positions in a POD – Non-Medical and Medical Models

Position JAS JITT POD Location POD RolePOD Supervisor G-1 #1, #7, #11, #12 Command Post (CP) Oversees POD Response Personal Coordinator 1-1 #1 Command Post Personnel Assignments Public Information Officer 1-2 #2 Command Post Media Liaison Officer 1-3 #2 Command Post EOC/Volunteer/Mutual Aid Liaison Safety Officer 1-4 Command Post POD SafetyMedical Task Force Leader G-2 #10, #11, #12 CP/POD Floor Supervise Medical UnitDispensing Crew Lead 2A-1 #10 POD Floor Oversees Dispensing Stations Dispensers 2A-3 #10 POD Floor Provides/Dispenses MCM Dispenser Assistants 2A-4 #10 POD Floor Assists with Dispensing MCMScreening/Triage Crew Leader 2B-1 #5,#10 POD Floor/Triage Oversees Screening and Triage Screeners 2B-4 #5, #10 POD Floor Reviews forms Medical Screener 2B-5 #5, #10 POD Floor Reviews forms for contraindications Triage Medical Staff 2B-2 #5 Triage Provide medical input for triage Triage Staff 2B-6 #5 Triage Screen clients entering POD First Aid 2B-3 #5, #6 POD Floor Provide First Aid Behavioral Health Staff 2C-1 #5 POD Floor Provide assistance

Facilities Unit Leader G-3 #7, #11, #12 Command Post Supervises Facility/Logistics Related Functions

Facilities Representative 3-1 Roving Provide Facility & Custodial Services

Information/Technology (IT) 3-2 #2, #3 Communications Set Up Computers, Software & Communications

Communications/Radio 3-3 #2 Communications Set Up & Operate Amateur Radio Communications

Inventory Manager 3-4#13, #8, #9 Inventory Control

Room

Account for all MCM and Supplies released & returned to Inventory Room

Runners (Supply) 3-6 #13, #8 Roving Stock/Restock Supplies throughout POD

Runners (MCM Supply) 3-5 #13, #8 Roving Supply/Resupply Dispensing StationsPOD Flow Unit Leader G-4 #1, #4, #7, #11, #12 CP/POD Floor Supervises POD Flow & Stations Greeters 4-1 POD Floor Greet, Direct & Distribute Forms Forms Distribution 4-2 POD Floor Distribute, Collect & Review Forms Interpreter 4-3 POD Floor Provide Language Interpretation


Flow Monitors 4-4 #7 POD Floor Direct foot traffic throughout POD

Health Educators 4-6 POD Floor Provide Information & Answer Questions

Security Unit Leader G-5 #1, #4, #11, #12 CP/POD Floor Supervise all aspects of POD Security

Security 5-1 Roving Provide Security & Crowd Control

Traffic Control/Parking 5-2 #4 Exterior Direct Traffic, Parking & Crowd Control

Additional Staffing Considerations for Medical Model Dispensing and Vaccination PODs

Position JAS JITT Location RoleMedical Unit Medication Lead #9 POD Floor Oversee Dispensing Stations Pharmacist 2A-2 #9 Vaccin. Stations Oversees Dosages & Inventory Room Vaccinators/Dispensers 2A-3 #10 Vaccin. Stations Dispense Medications Vaccinator/Dispenser Asst.2A-4 #10 Vaccin. Stations Assist in Dispensing Medications EMS/First Aid 2B-3 #6 First Aid Station Respond to POD Medical

Emergencies

Medical/Triage Physician 2B-2#5

Triage/POD Floor Screen & Assess Symptomatic Persons

Staff guidelines are general estimates; to be adjusted as needed.


Basic Example of Standard PODStep One: Fill Out Form Step Two: Show Form Step Three: Get Meds Step Four: Exit


Public Entrance

Greeters: Ask questions, distribute forms, & direct to enter POD

Step One: Fill Out Form

Station(s)

Step Two: Screening Form

Station(s)

Step Three: Dispensing Station(s)

Step Four: Exit and Data

Collection Station(s)

Public ExitSupplyReceivingInventory

Staff EntrancePOD Supervisor/Incident Command Post

Layout will vary based on facility. Unidirectional flow is essential.

Option: Merge steps two and three into one station.

Detailed Example of Standard POD


Public Entrance

Greeters: Ask questions, distribute forms, & direct to enter POD

SupplyReceivingInventory

Public ExitData Collection

Station(s)

Staff Entrance and Check InPOD Supervisor/Incident Command Post

Medical Triage Evaluator

Fill Out Form Station(s)

Screening Station(s)

Health EducationInterpretation

Medical Evaluation

Family and Assisted Dispensing

Vaccination Station(s)

Expressing DispensingVaccination Station(s)

Express DispensingVaccination Station(s)

Express DispensingVaccination Station(s)

Express Dispensing

Layout will vary based on facility. Unidirectional flow is essential.

Behavioral Health Station – position in POD for access to

the Public

EXTERNAL POINT OF DISPENSING CONSIDERATIONS

The list below are aspects to traffic flow and parking to consider when choosing facilities for Points of Dispensing (POD).

q As within the POD, unidirectional flow for the parking lot should be consideredq Entrance for the Public

o Entrances are accessible for populations with disabilities and access and functional needs

q Exit for the Publicq Parking for the Public

o Ensure parking is accessible for populations with disabilities and access and functional needs

o Reserve parking is recommended for populations with disabilities and access and functional needs

o Overflow parking lot with provided transportation to PODq Well-lighted parking lot(s), especially if POD is operating 24 hoursq Space for Parking Attendants and External Security to perform response operationsq Appropriate barriers, cones and signage to direct the Public into the POD

o Work with Public Works Departments, Emergency Management and Law Enforcement to procure necessary equipment

q Additional restroom facilities such as rented Port-a-Potties placed near POD entrancesq Loading dock or a secured separate entrance into the POD, near inventory control station

for medical countermeasures and supplies deliveredq Separate and secured entrance and exit for POD staff and volunteersq Separate and secured parking for POD staff and volunteersq Streets surrounding the POD can be adjusted for unidirectional flow to prevent traffic

bottlenecks entering and exiting the POD site


SIGNAGE AND POD COLOR CODES

Signageq Basis for the signage in this POD FOG is from the Washington State Department of

Health’s Medication Center. Links to the Adobe InDesign and PDF Formats for the signs listed below are in the Resources section.

q Size and layout of the POD influences number of signs and specific messages needed.q Various signs are translated in the following languages:

o Spanisho Russian

o Vietnameseo Chinese

q Suggested signs to use in PODs are:o Entranceo No entranceo Prohibitedo This is a medical services facilityo Symptoms signs according to

incidento Four Simple Stepso Step 1: Fill In Form

o Step 2: Show Formo Step 3: Please Waito Step 4: Turn In Form & Exito Thank you for your cooperationo First Aido Exito No Exito Arrows

q Additional signs area available by clicking here:o To POD (with arrows)o To Parking (with arrows)o Entrance (with arrows)o Restrooms (with arrows)o Pocket Communicator


https://www.oregon.gov/oha/PH/PREPAREDNESS/PARTNERS/Pages/Publicinforecources.aspx

Color Coding PositionsColor-coding each function or station to the staff vests may improve the throughput at the POD. Colors provide a visual path or cues to direct the public through the POD, if too many colors are not used. Access to vest and other identification for positions may not be available readily. Consider other options to identify POD stations and personnel working within the stations with resources available.

Recommendation to use vest with inserts to further identify POD staff by position. For insert templates, please refer to <<Annex XX>>.

*Example*

POD Staff Position Color-Code

POD Command Staff including: Supervisor, PIO, Safety, Liaison

White. This is consistent with ICS section color-codes.

Forms, Flow Monitors, Educators including: Greeters, Intake/Registration

Green. Consistent with the Washington State signs. Consideration: Place Educators or Flow Monitors in an alternate color to make them easier to see.

Screener and TriageOrange. Consistent with Washington State signs for screening. Consideration: Place Medical Screener is an alternate color to make them easier to see.

Dispensing Blue. Consistent with Washington State signs.

Runners Red

Vests, caps, nametags, floor tape and tablecloths are items that can be color-coded to distinguish the various functions. The use of small, hand-held flags is helpful to indicate an available dispenser or for POD staff to call a Runner.



SNS Resource Request Flow Chart (Local to State)

Additional resources required?

Note: Resources must be exhausted or expected to be exhausted locally and at the state level before federal assets are requested.

If state ESF8-Logistics Unit cannot find the resource, state ECC submits request to Federal Joint Field Office Request for SNS assets comes from the Governor or his/her designee (i.e., State Health Officer). President Declares Emergency

Resource demobilized or expended

Oregon’s state ESF -8 Logistics Unit in coordination with state RSS staff process resource requests and distribute orders and re-orders to PODs

SNS assets along with SNS technical staff deployed to Oregon’s Receiving, Staging and Storage (RSS) site

If county EOC cannot find the resource, county EOC submits request to Oregon’s ESF-8 Logistics Unit through the state Emergency Coordination Center (ECC)

Local resource request received by county Emergency Operations Center (EOC) ESF-8 Logistics Unit

Local supplies not sufficient to respond to Public Health threat – Local health department requests

resources from county EOC

Yes

No

MEDICAL CONSIDERATIONS

Standing Orders and Emergency DispensingSample standing orders for anthrax, tularemia and plague are available by clicking here. Dosing charts and standing orders provided are examples.

The Local Health Officer is responsible for signing the standing orders and approving all medication and vaccination dosing for all incidents as delineated in the IAP.

In an emergency, sufficient licensed health professionals (nurses, nurse practitioners, physician assistants, pharmacists, emergency medical technicians, and physicians) may not be available to dispense medications. In these instances, a health educator, other allied health professional, or trained staff may be used to dispense medications. Just-in-time-training with adequate supervision is provided to all dispensing and POD staff. Optimally, at least one pharmacist, physician or dentist is available for dispensing consultation at each POD. In emergency situations, consider integrating web-based screening into existing dispensing practices. Tools such as Dispense Assist can help increase efficiency in the POD. More information on Dispense Assist can be found in <<Annex XX>>.

Intake Form (Appendix D)Mass production of all forms, intake, and medication and disease fact sheets is the responsibility of each county. Intake forms here describe medical and non-medical model examples for modification in PODs.

The full-page form, with multiple household members’ information, is given to the public to complete prior to receiving medication when a modified medical model is in use at a POD.

An individual may pick up medication for him/herself and other people, who may or may not live within the same household. It is at the discretion of the POD Supervisor to determine if an individual is requesting an unreasonable number of doses.

The half page form, containing just three questions, is given to the public to complete when a non-medical model is used at a POD.

Pediatric Suspension Dosing ChartsLimited amounts of pediatric suspension are available through the SNS, so this guide provides links to emergency dosing charts for infants and children courtesy of the Oregon Health Authority. See reference section for the Model Standing Orders for Anthrax. Due to limited quantities of suspension, most of pediatric dispensing is handled through pill crushing.


http://www.dispenseassist.net/

https://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Pages/stdgordr.aspx

Information on pill crushing of Doxycycline for children and those who cannot swallow pills: Not everyone is able to swallow pills or requires a full dose. The United States Food and Drug Administration (FDA) provides information on how to prepare Doxycycline for those with swallowing difficulties. Double and single sided pamphlets are available in both English and Spanish entitled, “In an Emergency: How to Prepare Doxycycline for Children and Adults Who Cannot Swallow Pills” electronically by clicking here. English versions are included in the Forms Appendix <<D, 15a and 15b>>.Note: The FDA does not approve the crushing of Ciprofloxacin. Infants, children and adults who cannot swallow pills are given Doxycycline along with the FDA pill crushing instructions listed above.

Post exposure dispensing AlgorithmThe algorithm on the next page is a tool for determining who gets what medications in an antibiotic mass prophylaxis campaign. This algorithm is based on a modified medical model so only takes into account the most important medical interactions. This algorithm takes into account the new guidelines by the FDA that do not support the crushing of Ciprofloxacin pills. The major demographic group that requires consideration to this issue is children under nine years of age who cannot swallow pill


https://www.fda.gov/Drugs/EmergencyPreparedness/BioterrorismandDrugPreparedness/ucm130996.htm

RESOURCES

MCM/POD/JITT InformationPortland Metropolitan Cities Readiness Initiativehttp://crinorthwest.org/index.html

Inclusive Just-In-Time Training (IJITT) Toolkit for Mass Prophylaxis/POD Operationshttp://crinorthwest.org/pod-tools.html

Oregon Health Authority Medical Countermeasureshttps://www.oregon.gov/oha/PH/PREPAREDNESS/PARTNERS/Pages/medicalcountermeasures.aspx

Washington State Department of Health Medical Centerhttps://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/EmergencyPreparedness/EmergencyCommunicationsToolkit/MedicationCenterResources

MedicalDispense Assisthttps://www.dispenseassist.net/

Model Standing Orders from Oregon Health Authority Public Health Divisionhttps://www.oregon.gov/oha/PH/PreventionWellness/VaccinesImmunization/ImmunizationProviderResources/Pages/stdgordr.aspx

U.S. Food and Drug Administration Emergency Use Authorizationhttps://www.fda.gov/emergencypreparedness/counterterrorism/ucm182568.htm

CommunicationsOregon Health Authority Health Alert Network (HAN)https://www.oregon.gov/oha/PH/Preparedness/Partners/HealthAlertNetwork/Pages/index.aspx

Oregon Health Authority Crisis and Emergency Risk Communications Toolkitshttps://www.oregon.gov/oha/PH/PREPAREDNESS/PARTNERS/Pages/riskcommunicationtools.aspx

Emergency Preparedness and ResponseOregon Health Authority Health Security Preparedness and Response https://www.oregon.gov/oha/PH/Preparedness/Pages/index.aspx

CDC Emergency Preparedness and Responsehttps://emergency.cdc.gov/

Health and Human Services Public Health Emergencyhttps://www.phe.gov/preparedness/pages/default.aspx


https://www.phe.gov/preparedness/pages/default.aspx

https://emergency.cdc.gov/

https://www.oregon.gov/oha/PH/Preparedness/Pages/index.aspx

https://www.oregon.gov/oha/PH/PREPAREDNESS/PARTNERS/Pages/riskcommunicationtools.aspx

https://www.oregon.gov/oha/PH/Preparedness/Partners/HealthAlertNetwork/Pages/index.aspx

https://www.fda.gov/emergencypreparedness/counterterrorism/ucm182568.htm



https://www.dispenseassist.net/

https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/EmergencyPreparedness/EmergencyCommunicationsToolkit/MedicationCenterResources

https://www.doh.wa.gov/ForPublicHealthandHealthcareProviders/EmergencyPreparedness/EmergencyCommunicationsToolkit/MedicationCenterResources

https://www.oregon.gov/oha/PH/PREPAREDNESS/PARTNERS/Pages/medicalcountermeasures.aspx

https://www.oregon.gov/oha/PH/PREPAREDNESS/PARTNERS/Pages/medicalcountermeasures.aspx

http://crinorthwest.org/pod-tools.html

http://crinorthwest.org/index.html

Population Data SourcesPortland State University Population Research Centerhttps://www.pdx.edu/prc/about-prc

U.S. Census Bureau Fact Finderhttps://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml


https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml

https://www.pdx.edu/prc/about-prc

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